CN102958448B - Medical image diagnostic device and cardiac measurement value display method - Google Patents

Medical image diagnostic device and cardiac measurement value display method Download PDF

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CN102958448B
CN102958448B CN201180032615.7A CN201180032615A CN102958448B CN 102958448 B CN102958448 B CN 102958448B CN 201180032615 A CN201180032615 A CN 201180032615A CN 102958448 B CN102958448 B CN 102958448B
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heart
signature waveform
cycle
cardiac
measurement
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CN102958448A (en
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西浦朋史
樫山贵广
林哲矢
长野智章
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Fujifilm Healthcare Corp
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Hitachi Medical Corp
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0883Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316Modalities, i.e. specific diagnostic methods
    • A61B5/318Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346Analysis of electrocardiograms
    • A61B5/349Detecting specific parameters of the electrocardiograph cycle
    • A61B5/352Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461Displaying means of special interest
    • A61B8/463Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5223Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment

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Abstract

The medical image diagnostic device of the present invention is a medical image diagnostic device provided with a tomography image construction unit for constructing a tomography image of a subject body, a measurement unit for measuring cardiac measurement values on the basis of the tomography image; and an image display unit for displaying the tomography image and the cardiac measurement values; wherein the medical image diagnostic device is provided with a characteristic waveform detection unit for detecting a characteristic waveform from the shape of the ECG waveform of the subject body; and a cardiac period setting unit which treats as a first characteristic waveform a characteristic waveform which, among characteristic waveforms detected at the characteristic waveform detection unit, has the smallest difference in time relative to a reference time, and sets a cardiac period, which is set according to a second characteristic waveform succeeding the first characteristic waveform, and the first characteristic waveform; wherein the measurement unit measures the cardiac measurement values on the basis of the tomography image, the characteristic waveform, and the cardiac period.

Description

Medical diagnostic imaging apparatus and cardiac measurement value display method
Technical field
The present invention relates to the measurement point of use to faultage image setting to carry out medical diagnostic imaging apparatus and the cardiac measurement value display method of the measurement of bio-tissue.
Background technology
In existing medical diagnostic imaging apparatus, operator uses the input part such as mouse or tracking ball to carry out setting measurement point on accessed faultage image.Then, medical diagnostic imaging apparatus measures cardiac measurement value based on set measurement point, and shows cardiac measurement value.
Specifically, if operator sets multiple measurement point on faultage image, then the area, the volume that in the measurement application of medical diagnostic imaging apparatus, measure the distance between measurement point, are surrounded by multiple measurement point.In addition, if operator sets regulation region on faultage image, then area, volume in the regulation region set by calculating in measurement application.
In the measurement application of medical diagnostic imaging apparatus, display measurement point on faultage image also, when performing measurement, carries out the action of automatic setting measurement point.(such as, patent documentation 1).
At first technical literature
Patent documentation
Patent documentation 1: Japanese Unexamined Patent Publication 2005-224465 publication
Summary of the invention
Invent technical problem to be solved
In patent documentation 1, do not consider upgraded by each heart upgraded the successively cycle of clapping and measuring the situation of cardiac measurement value.Thus, in patent documentation 1, do not upgrade cardiac measurement value in each heart cycle of clapping and show.
In the present invention, its object is to provide a kind of upgraded by each heart upgraded the successively cycle of clapping and measuring medical diagnostic imaging apparatus and the cardiac measurement value display method of cardiac measurement value.
For the technical scheme that technical solution problem adopts
In order to reach above-mentioned purpose, in the present invention, form the faultage image of subject, shape according to electrocardiographic wave detects signature waveform, the setting heart claps the cycle, this heart cycle of clapping be by among the described signature waveform detected and signature waveform that time difference between fiducial time is minimum be set to the 1st signature waveform and cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform, measure cardiac measurement value based on formed described faultage image, show described faultage image and described cardiac measurement value.
Specifically, medical diagnostic imaging apparatus of the present invention possesses: faultage image constituting portion, and it forms the faultage image of subject; Measurement section, it measures cardiac measurement value based on described faultage image; And image displaying part, it shows described faultage image and described cardiac measurement value, and the feature of described medical diagnostic imaging apparatus is also possess: signature waveform test section, and it detects signature waveform according to the shape of the electrocardiographic wave of described subject; Cycle set portion is clapped with the heart, its setting heart claps the cycle, this heart cycle of clapping be by among the signature waveform detected by described signature waveform test section and signature waveform that time difference between fiducial time is minimum be set to the 1st signature waveform and cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform, described measurement section measures cardiac measurement value based on described faultage image, described signature waveform and the described heart cycle of clapping.
In addition, cardiac measurement display packing of the present invention is characterized in that comprising: the step forming the faultage image of subject; The step of signature waveform is detected according to the shape of the electrocardiographic wave of described subject; The setting heart claps the step in cycle, this heart cycle of clapping be by among the described signature waveform detected and signature waveform that time difference between fiducial time is minimum be set to the 1st signature waveform and cycle set by and then the 1st signature waveform continuous print the 2nd signature waveform and the 1st signature waveform; The step that the cycle measures cardiac measurement value is clapped based on described faultage image, described signature waveform and the described heart; With the step showing described faultage image and described cardiac measurement value.
Invention effect
According to the present invention, play following effect, that is: can be provided in and upgraded by each heart upgraded the successively cycle of clapping and measure medical diagnostic imaging apparatus and the cardiac measurement value display method of cardiac measurement value.
Accompanying drawing explanation
Fig. 1 is the figure representing that the entirety of medical diagnostic imaging apparatus of the present invention (diagnostic ultrasound equipment) is formed.
Fig. 2 is the figure representing embodiments of the invention 1.
Fig. 3 is the figure representing embodiments of the invention 1.
Fig. 4 is the flow chart of the action representing embodiments of the invention 1.
Fig. 5 is the figure representing embodiments of the invention 2.
Fig. 6 is the figure representing embodiments of the invention 2.
Fig. 7 is the figure representing embodiments of the invention 3.
Fig. 8 is the figure representing embodiments of the invention 4.
Detailed description of the invention
Below, utilize accompanying drawing to illustrate and be suitable for medical diagnostic imaging apparatus of the present invention.
[embodiment 1]
Fig. 1 is the block diagram representing the formation being suitable for medical diagnostic imaging apparatus of the present invention.At this, as medical diagnostic imaging apparatus one example and diagnostic ultrasound equipment is described.
As shown in Figure 1, diagnostic ultrasound equipment possesses: touch the ultrasound probe 12 used in subject 10; Separate interval via ultrasound probe 12 and repeatedly send hyperacoustic sending part 14 to subject 10; Using the acceptance division 16 that the ultrasound wave reflected from subject 10 receives as reflection echo signal; To the ultrasonic transmission/reception control part 18 that sending part 14 and acceptance division 16 control; The reflection echo received by acceptance division 16 is carried out to the phase modulation adder 20 of phase modulation additive operation; The faultage image of subject 10, the faultage image constituting portion 22 of such as black and white faultage image is formed based on the RF signal frame data from phase modulation adder 20; The black and white scan converter 24 that the mode matched according to the display with image displaying part 26 converts the faultage image data exported from faultage image constituting portion 22; And show the image displaying part 26 of the images such as faultage image.
And diagnostic ultrasound equipment also possesses: by being installed in the hope position of subject 10, the hands of such as subject 10 and the electrocardiographic recorder of foot to detect the electrocardiographic wave test section 30 of electrocardiographic wave; The electrocardiographic wave detected by electrocardiographic wave test section 30 is resolved and the signature waveform test section 32 that the signature waveform of electrocardiographic wave is detected; And use the shortest signature waveform (the 1st up-to-date signature waveform) of the time difference between the moment of electrocardiographic wave that is among the signature waveform that detected by signature waveform test section 32 and actual time (current) and set the heart with the 1st signature waveform continuous print signature waveform (the 2nd signature waveform) and clap the heart in cycle and clap cycle set portion 34.
At this, about the 1st signature waveform, although be illustrated according to the mode of the shortest signature waveform of time difference selected between actual time (current), but also the signature waveform in the moment of the 2nd signature waveform of above-mentioned explanation can be set as the 1st signature waveform, the tense wholeheartedly clapped before it (tense) is set to the 2nd signature waveform.Like this, even if from the current electrocardiographic wave carrying out reviewing, as long as the 1st signature waveform and the 2nd both signature waveforms are continuously, the operation just undertaken by the operator of operating portion 40 is at random selected.Be defined as in present specification: any selection carrying out the 1st signature waveform and the 2nd signature waveform in the electrocardiographic wave determined fiducial time.That is, the fiducial time that the described heart is clapped in cycle set portion can be actual time (current), and the next heart that also can set the moment wanting arbitrarily to select claps the cycle.
Operator sets multiple measurement point to the faultage image that image displaying part 26 demonstrates.Possesses measurement section 36, this measurement section 36 is within the heart bat cycle set out by heart bat cycle set portion 34, measure the cardiac measurement values such as the length between the area of heart, the volume of heart, measurement point based on set multiple measurement points, and make image displaying part 26 show cardiac measurement value.In addition, possess: the operating portion 40 being carried out the instructions such as setting measurement point by operator; And the control part 42 of the control of each element is carried out according to the instruction of operating portion 40.Be configured with in operating portion 40: for carry out the location of measurement point etc. tracking ball, for the execute key of executable operations, the freezing key etc. for making faultage image freeze.
At this, diagnostic ultrasound equipment is described in detail.Ultrasound probe 12 arranges multiple agitator and is formed, and has and receive and dispatch hyperacoustic function via agitator to subject 10.Sending part 14 has following function: generate for driving ultrasound probe 12 to produce hyperacoustic transmission wave impulse, and sent hyperacoustic collecting a little is set in certain degree of depth.In addition, acceptance division 16 has following function: generate RF signal namely receive ripple signal for carrying out amplification based on the hyperacoustic reflection echo signal received by ultrasound probe 12 with the gain of regulation.Phase modulation adder 20 has following function: input the RF signal after being amplified by acceptance division 16 to carry out phase controlling, collects a formation ultrasonic beam to generate RF signal frame data for one or more.
Faultage image constituting portion 22 inputs RF signal frame data from phase modulation adder 20 to carry out the signal processing such as gain calibration, logarithmic compression, detection, emphasizing contour, Filtering Processing, thus obtains faultage image data.In addition, black and white scan converter 24 is configured to comprise: the faultage image data exported from faultage image constituting portion 22 is transformed to the A/D changer of digital signal, the frame memory of the multiple faultage image datas after time series storage is transformed and controller.Faultage image data in the subject 10 that frame memory is preserved by this black and white scan converter 24 as Image Acquisition, and reads accessed disconnected picture view data in the mode that the television set of image displaying part 26 is synchronous.
Signature waveform test section 32 is resolved the electrocardiographic wave detected by electrocardiographic wave test section 30, and detects the signature waveform occurred within each heart bat cycle according to the shape of electrocardiographic wave.Its longitudinal axis of the electrocardiographic wave detected by electrocardiographic wave test section 30 voltage (potential difference) represents, transverse axis represented with the time.Signature waveform test section 32 utilizes waveform, the i.e. voltage of R ripple this characteristic maximum that R ripple is maximum among the electrocardiographic wave detected by electrocardiographic wave test section 30, detects the R ripple as signature waveform.
Specifically, signature waveform test section 32 for the electrocardiographic wave detected by electrocardiographic wave test section 30 voltage and compare with predetermined threshold value, detect it is R ripple when voltage has exceeded threshold value.This threshold value is set according to the mode of the peak value (maximum voltage) that can detect electrocardiographic wave.In addition, signature waveform test section 32 also can utilize differential is carried out to the electrocardiographic wave detected by electrocardiographic wave test section 30 and the differential value obtained to detect R ripple.In addition, in the present embodiment, although be illustrated the example of the signature waveform that have detected R ripple, the signature waveform detected by signature waveform test section 32 also can be the signature waveform such as P ripple, Q ripple, S ripple, T ripple of electrocardiographic wave.The kind of the signature waveform detected by signature waveform test section 32 can be selected among R ripple, P ripple, Q ripple, S ripple, T ripple etc. by operating portion 40.
Selection function according to the kind of signature waveform can separate use as follows: as long as use R ripple in the relaxing period detecting left ventricle, in the relaxing period detecting left atrium, use P ripple.
In addition, in clinical, can be used in paying close attention to " T wave amplitude is low " or " Q ripple R ripple S grows during ripple singularly " these characteristics in the usual diagnosis finding disease.
In addition, when R ripple cannot be detected clearly, the R ripple moment can be used as in analog by after such as 500ms the moment from P ripple.
The heart claps the signature waveform that cycle set portion 34 occurred based on each heart detected by signature waveform test section 32 cycle of clapping, particularly based on the 1st up-to-date signature waveform with set the heart with the 1st signature waveform continuous print the 2nd signature waveform and clap the cycle.2nd signature waveform is the new signature waveform being only second to the 1st signature waveform.Thus, by the heart clap the heart that sets out of cycle set portion 34 clap the cycle relative to actual time (current) moment and become the up-to-date heart and clap the cycle.
Measurement section 36 for exporting from black and white scan converter 24 and the faultage image that (current) is updated in actual time, measure utilize the 1st up-to-date signature waveform and and heart bat cycle set by the 1st signature waveform continuous print the 2nd signature waveform in, the cardiac measurement value such as length, ejection fraction (EF value) between the area of heart, the volume of heart, 2 measurement points.Then, measurement section 36 makes image displaying part 26 show cardiac measurement value together with the faultage image that (current) is updated in actual time.
Utilize Fig. 2 to specifically describe the present embodiment.Fig. 2 is an example of the image be shown in image displaying part 26.The cardiac measurement value 80 showing the electrocardiographic wave 50 detected by electrocardiographic wave test section 30, the faultage image 70 exported from black and white scan converter 24 and measured by measurement section 36 in image displaying part 26.
Electrocardiographic wave 50 is detected by electrocardiographic wave test section 30, and electrocardiographic wave 50 demonstrates the display tense labelling 52 in the moment (tense) representing actual time (current).The renewal of display tense labelling 52 and electrocardiographic wave 50 side by side on time orientation (right direction) move and be shown.If display tense labelling 52 reaches right-hand member, then show tense labelling 52 and move to left end, be side by side repeatedly shown with the renewal of electrocardiographic wave 50.Electrocardiographic wave after the electrocardiographic wave 50 shown in the left side of display tense labelling 52 is updated.
Demonstrate in image displaying part 26: the R ripple 58 of the R ripple 56 of that detected by signature waveform test section 32, up-to-date for the moment of actual time (current) R ripple 54, and then R ripple 54 and and then R ripple 56.The R ripple detected by signature waveform test section 32 is the one of signature waveform.
R ripple 54 is R ripples up-to-date for the moment of actual time (current), becomes up-to-date R ripple.R ripple 56 is the 2nd new R ripples for the moment of actual time (current).Similarly, R ripple 58 is the 3rd new R ripples for the moment of actual time (current).
The heart claps cycle set portion 34 based on the R ripple as the signature waveform detected by signature waveform test section 32, sets to utilize up-to-date R ripple 54 and be only second to the new heart set by R ripple 56 of R ripple 54 to clap cycle A (R-R cycle).The heart clipped by R ripple 54 and R ripple 56 claps cycle A to be become the heart in 1 cycle clipped by up-to-date signature waveform and the 2nd new signature waveform and claps the cycle.Thus, become the heart the shortest with the difference in the moment of actual time (current) by the heart bat cycle A that R ripple 54 and R ripple 56 clip and clap the cycle.The heart the shortest with the difference in the moment of actual time (current) cycle of clapping also can be called the up-to-date heart and clap the cycle.
Clapping on the suitable electrocardiographic wave of cycle A 50 with the heart, demonstrating electrocardiographic wave labelling 60 at image displaying part 26, being set by heart bat cycle set portion 34 up-to-date heart bat cycle A can be identified.About electrocardiographic wave labelling 60, such as illustrate by the line type (thick line, dotted line etc.) different with electrocardiographic wave 50 clapping on the suitable electrocardiographic wave of cycle A 50 from the heart clipped by R ripple 54 and R ripple 56, or illustrate by the color different with electrocardiographic wave 50 (red, blue etc.) clapping on the suitable electrocardiographic wave of cycle A 50 from the heart.
Faultage image 70 is cross-section images of the heart of subject 10, such as, be apex two chamber picture (A2C).Faultage image 70 is provided with multiple measurement point.In the present embodiment, the measurement point of 9 is set along the inwall of the heart be shown as faultage image.Region 76 is the regions surrounded by multiple measurement point.
Measurement section 36 is measured and is clapped the cardiac measurement value such as length, ejection fraction between the area of the relaxing period of cycle A and Syst, heart, the volume of heart, 2 measurement points by the heart heart clapped set by cycle set portion 34.
Relaxing period refers to after heart contraction diastole, to heart, injects the interval of blood from whole body.Systole refers to the interval that blood is sent to whole body by heart contraction.Relaxing period is the interval after R wavefront, such as, be the interval after R wavefront 500ms to R ripple till 50ms.Systole is the interval have passed through the stipulated time from R after, such as, be the interval after R ripple after 50ms to R ripple till 300ms.R ripple is included in the interval of relaxing period, R wave table show systole start before diastasis.
First, measurement section 36 is measured and is clapped length between the area of the mesodiastolic heart of cycle A, the volume of heart, 2 measurement points by the heart heart clapped set by cycle set portion 34.Measurement section 36 such as measure as the heart clap the moment of the ED R ripple of cycle A, length between the area of heart, the volume of heart, 2 measurement points.Refer to the period that the diastole of heart terminates diastasis.The ED R ripple clapping cycle A as the heart both can be R ripple 54 up-to-date for the moment of actual time (current), also can be the R ripple 56 of and then R ripple 54.In addition, in the present embodiment, because prerequisite measures ejection fraction, thus suppose that the moment at the R ripple 56 of heart bat cycle A carries out the measurement of relaxing period.Measurement section 36 measures the length between the area of the heart in the moment of R ripple 56, the volume of heart, 2 measurement points.Length between the area of the heart of the relaxing period measured by measurement section 36, the volume of heart, 2 measurement points is shown as the cardiac measurement value 80 of image displaying part 26.
Further, measure in the same manner as the measurement that measurement section 36 and the heart clap the relaxing period of cycle A and clap length between the area of the Syst heart of cycle A, the volume of heart, 2 measurement points by the heart heart clapped set by cycle set portion 34.Measurement section 36 is such as measured from the moment of R ripple and be have passed through length between the area of the end-systolic heart after the stipulated time, the volume of heart, 2 measurement points.
End-systole refers to the period that the contraction of heart terminates, be such as the volume of heart become minimum when.All tomograph picture frames that measurement section 36 is clapped in cycle A (the previous heart claps the cycle) for the heart carry out volume computing, determine the tomograph picture frame of the minimum volume of giving heart, determine the end-systolic moment thus.Then, measurement section 36 uses end-systolic tomograph picture frame to measure the length between the area of heart, the volume of heart, 2 measurement points.
Measurement section 36 can measure the length between 2 measurement points being optionally set.In addition, measurement section 36, by combining multiple measurement results of the length between 2 measurement points being freely set, can measure the cardiac measurement such as long axis length or minor axis length value thus.In addition, measurement section 36 can also measure ratio and the L Index value of the long axis length of different section.
In addition, measurement section 36 measures the change of the volume of heart in advance, becomes the time (T1) minimum moment based on the change volume measured from the moment of R ripple to heart of the volume of measured heart.Then, measurement section 36 is measured from the moment of R ripple 56 and be have passed through length between the area of the end-systolic heart after the stipulated time (T1), the volume of heart, 2 measurement points.
At this, the measuring method of the area of heart is described.The area in the region 76 surrounded by multiple measurement point is measured based on the pixel count comprised in region 76.First, the pixel count in measurement section 36 pairs of regions 76 counts.Measurement section 36 grasps every 1mm in advance 2pixel count, area conversion is carried out to the pixel count be counted out in region 76, thus the area of measured zone 76.Such as, if measurement section 36 is in advance by every 1mm 2pixel count grasp as 10 pixels, if the pixel count be then counted out in region 76 is 5000 pixels, such area is scaled 500mm 2.
Secondly, the measuring method of the volume of heart is described.Measurement section 36 uses simpson's method (Simpson) to measure the volume of heart.Simpson's method is following method: on longitudinally, the region 76 surrounded by multiple measurement point is divided into rectangular area, obtain the area of rectangular area, calculate volume for each rectangular area, be added obtained volume by the rectangular area after segmentation, obtain volume thus.
Secondly, the measurement of length method between 2 measurement points is described.First, operator utilizes operating portion 40 to set 2 measurement points within 9 measurement points.At this, suppose to set measurement point 72 and measurement point 74.Distance between set measurement point 72 and measurement point 74 is measured as the length between 2 measurement points by measurement section 36.
Afterwards, measurement section 36 carrys out computing ejection fraction according to the volume of measured ED heart and the volume of end-systolic heart.Ejection fraction is obtained according to the following formula of the volume of heart and the volume of Syst heart that employ relaxing period.
{ formula 1}
Ejection fraction (%)=(Va (volume of ED heart)-Vb (volume of end-systolic heart)/Va × 100
Ejection fraction is utilized the volume of the heart in the moment as ED R ripple 56 and calculates as the minimum volume of end-systolic heart by measurement section 36.Ejection fraction is the evaluation of estimate of the contractile function representing heart.In addition, in measurement section 36, except ejection fraction, the measured value in diastasis and the measured value in end-systole can also be combined and calculate and represent that the heart claps the desired value of the causing circulatory function of cycle A.Such as, measurement section 36 utilizes the difference of the volume of the volume of ED heart and end-systolic heart based on following formula, can measure cardiac output or a cardiac output that the heart claps the blood in cycle A.
{ formula 2}
Cardiac output=heart umber of beats × (Va-Vb)
(formula 3}
A cardiac output=Va-Vb
Secondly, Fig. 3 is utilized to illustrate renewal cardiac measurement value 80.Fig. 3 (a) represents that the heart shown in Fig. 2 claps the form of state.Fig. 3 (b) represents that the heart illustrated from Fig. 3 (a) state of clapping have passed through the form that the heart after the stipulated time claps state.Fig. 3 (c) represents that the heart illustrated from Fig. 3 (b) state of clapping have passed through the form that the heart after the stipulated time claps state.
The display tense labelling 52 in the moment (tense) of the expression actual time (current) that Fig. 3 (a) illustrates above moves and is shown at time orientation (right direction) with the renewal of electrocardiographic wave 50 in the lump.As shown in Fig. 3 (b), when display tense labelling 52 reaches the R ripple 62 as new R ripple, signature waveform test section 32 detects the R ripple 62 as signature waveform.R ripple 62 is R ripples up-to-date for the moment of actual time (current), becomes up-to-date R ripple.R ripple 54 becomes the 2nd new R ripple for the moment of actual time (current).
The heart is clapped cycle set portion 34 and is reset heart bat cycle B (R-R cycle) clipped by the R ripple 54 of up-to-date R ripple 62 and and then R ripple 62.Thus, under the heart bat state that Fig. 3 (b) illustrates, become the up-to-date heart by the heart bat cycle B that R ripple 62 and R ripple 54 clip and clap the cycle.
Then, measurement section 36 is for the faultage image 70 being updated to actual time (current), and the heart measured set by heart bat cycle set portion 34 claps the cardiac measurement value such as length, ejection fraction between area in cycle B, heart, the volume of heart, 2 measurement points.Because it is same that the heart claps the measurement that measurement in the relaxing period of cycle B and systole and the heart clap in the relaxing period of cycle A and systole, so the description thereof will be omitted.The heart measured by measurement section 36 is clapped the length between the area of the relaxing period of cycle B and Syst heart, the volume of heart, 2 measurement points and is overwritten in cardiac measurement value that past measurement goes out as the cardiac measurement value 80 of image displaying part 26 and shows.
Thus, whenever represent actual time (current) moment display tense labelling 52 by new signature waveform time, detects whenever signature waveform test section 32 signature waveform made new advances time, the heart clap cycle set portion 34 set the heart bat cycle.Specifically, the heart is clapped cycle set portion 34 and is set the heart and clap the cycle, and this heart cycle of clapping is the cycle set by the 2nd signature waveform according to the 1st up-to-date signature waveform that newly detects and and then the 1st signature waveform.Thus, when signature waveform test section 32 detects the signature waveform made new advances, the heart is clapped cycle set portion 34 and is upgraded the heart bat cycle, the cycle that the heart can be clapped ensure up-to-date all the time thus.
Then, measurement section 36 measures the cardiac measurement value that the heart that is updated when detecting the signature waveform made new advances at every turn claps length between the area of the relaxing period in cycle and Syst heart, the volume of heart, 2 measurement points, ejection fraction.The heart after image displaying part 26 display is updated claps the relaxing period in cycle and Syst cardiac measurement value 80.
As shown in Fig. 3 (c), when detect the R ripple 62 as signature waveform from signature waveform test section 32 to detecting next R ripple during in, image displaying part 26 continues the cardiac measurement value 80 that the display heart claps the length between the area of the heart in the relaxing period of cycle B and systole, the volume of heart, 2 measurement points.
Operator is at the freezing button of arbitrary moment (tense) press operating part 40, control part 42 can make the faultage image 70 being updated to actual time (current) freeze in image displaying part 26 thus, and the renewal of cardiac measurement value 80 is stopped.Operator can confirm the frozen faultage image 70 that demonstrates on image displaying part 26 and up-to-date cardiac measurement value 80.In addition, while the cardiac measurement value 80 that operator can be updated in reference, make to be applicable to the disconnected of diagnosis and freeze as image 70 and show.
Fig. 4 illustrates the flow chart of the action representing the present embodiment.
(S101) utilize the ultrasound probe 12 used with abutting with subject 10, separate interval and repeatedly ultrasound wave is received and dispatched to subject 10, show the faultage image 70 of subject 10 thus at image displaying part 26.The faultage image 70 demonstrated at image displaying part 26 is updated to actual time (current).
(S102) operator is by the freezing button of press operating part 40, thus by control part 42, the faultage image 70 demonstrated at image displaying part 26 is freezed.Frozen faultage image 70 is demonstrated at image displaying part 26.Operator rotates by making the tracking ball of operating portion 40, carries out the location of measurement point thus on frozen faultage image 70.Then, operator by the execute key of press operating part 40, thus by the position setting measurement point of locating.So, multiple measurement point can be set at frozen faultage image 70.By removing freezing of faultage image 70, thus faultage image 70 actual time (current) is shown.Multiple measurement point is followed the trail of according to the action of faultage image 70.Measurement section 36 is obtained multiple measurement point and where is moved to successively along with beating of heart.Specifically, measurement section 36 sets the region comprising the arbitrary shape near measurement point and measurement point on faultage image, carries out relevant treatment to follow the trail of measurement point for this region between 2 faultage images.
In addition, control part 42 can also clap the tissue profile of resolving the faultage image 70 being updated to actual time (current) by each heart, and based on tissue profile automatically setting measurement point.Specifically, although not diagram, control part 42 has based on the data base preserved by the diagnosis image information of the tissue of Templated subject.Control part 42 will be updated to being compared by Templated diagnosis image information of preserving in the faultage image of actual time (current) and data base, carrys out setting measurement point based on comparison result according to tissue profile.Such as, multiple measurement point is set along tissue profile (inner chamber of heart).
(S103) measurement section 36 utilizes the measurement point followed the trail of on the faultage image 70 being updated to actual time (current), the heart measured set by the 2nd signature waveform of the 1st up-to-date signature waveform and and then the 1st signature waveform clap the cycle, the cardiac measurement value such as length, ejection fraction between the area of heart, the volume of heart, 2 measurement points.
(S104) measurement section 36 measures the cardiac measurement value that the heart be updated when at every turn newly detecting signature waveform claps length between the area of the relaxing period in cycle and Syst heart, the volume of heart, 2 measurement points, ejection fraction, and upgrades cardiac measurement value 80.
(S105) operator selects the measurement whether terminating cardiac measurement value.When continuing to measure, turning back to S104 and continuing to measure.When terminating to measure, tenth skill.
Above, embodiment 1 is a kind of medical diagnostic imaging apparatus, possesses: faultage image constituting portion, and it forms the faultage image of subject, measurement section, it measures cardiac measurement value based on described faultage image, and image displaying part, it shows described faultage image and described cardiac measurement value, and described medical diagnostic imaging apparatus also possesses: signature waveform test section, and it detects signature waveform according to the shape of the electrocardiographic wave of described subject, cycle set portion is clapped with the heart, its setting heart claps the cycle, this heart cycle of clapping be when by among the signature waveform detected by described signature waveform test section and signature waveform that time difference between fiducial time is minimum is set to the 1st signature waveform cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform, described measurement section is based on described faultage image, described signature waveform and the described heart cycle of clapping measures cardiac measurement value, thus can provide a kind of upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, embodiment 1 comprises: the step forming the faultage image of subject; The step of signature waveform is detected according to the shape of the electrocardiographic wave of described subject; The setting heart claps the step in cycle, this heart cycle of clapping be when by among the described signature waveform detected and signature waveform that time difference between fiducial time is minimum is set to the 1st signature waveform utilize cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform; The step that the cycle measures cardiac measurement value is clapped based on described faultage image, described signature waveform and the described heart; With the step showing described faultage image and described cardiac measurement value, thus can provide a kind of and upgraded by each heart upgraded the successively cycle of clapping and measuring the cardiac measurement value display method of cardiac measurement value.
In addition, even if described measurement section measurement index value, this desired value represents that clapping by the described heart the described heart that cycle set portion sets out claps the relaxing period in cycle and Syst cardiac measurement value or causing circulatory function, also can provide a kind of and is being upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, even if the described heart claps actual time fiducial time (current) in cycle set portion, also can provide a kind of and upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, even if any one among the R ripple of the described electrocardiographic wave of described signature waveform, P ripple, Q ripple, S ripple, T ripple, also can provide a kind of and upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, also the operating portion that the faultage image demonstrated described image displaying part sets multiple measurement point can be possessed, described measurement section measures at least one the cardiac measurement value among the ejection fraction of the area of heart, the volume of heart, heart based on set multiple measurement points, so also can provide a kind of and is being upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, also can when each described signature waveform test section detects the signature waveform made new advances, the described heart is clapped cycle set portion and is utilized the 2nd signature waveform of the 1st signature waveform that newly detects and and then described 1st signature waveform to set the heart bat cycle, so also can provide a kind of and is being upgraded by each heart bat cycle upgraded successively and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, described measurement section is measured the heart that also can be updated when each described signature waveform test section detects the signature waveform made new advances and is clapped the diastasis in cycle and end-systolic cardiac measurement value, so also can provide a kind of and is being upgraded by each heart upgraded the successively cycle of clapping and measuring the medical diagnostic imaging apparatus of cardiac measurement value.
In addition, according to embodiment 1, possessing the faultage image constituting portion 22 of the faultage image forming subject 10, show the image displaying part 26 of the faultage image be made up of faultage image constituting portion 22, and among the medical diagnostic imaging apparatus of measurement section 36 measuring cardiac measurement value based on the faultage image demonstrated at image displaying part 26, possess: the electrocardiographic wave detected from subject 10 is resolved and detects the signature waveform test section 30 of signature waveform according to the shape of electrocardiographic wave, and clap the heart in cycle based on the signature waveform detected by signature waveform test section 30 heart set set by the 2nd signature waveform utilizing the 1st up-to-date signature waveform and and then the 1st signature waveform and clap cycle set portion 34, measurement section 36 measures the cardiac measurement value in the heart bat cycle, image displaying part 26 shows cardiac measurement value.Thereby, it is possible to measure cardiac measurement value for the faultage image being updated to actual time (current) by each heart cycle of clapping, make to upgrade cardiac measurement value together with being updated to the faultage image of actual time (current).
In addition, in embodiment 1, the heart is clapped cycle set portion 34 and is set 1 cycle as the heart bat cycle A clipped by the R ripple 56 of up-to-date R ripple 54 and and then R ripple 54 based on the R ripple as the signature waveform detected by signature waveform test section 32, but also can set multiple cycle.Heart bat cycle set portion 34 such as can also set clapped for 2 cycles by up-to-date R ripple 54 with as the heart that the R ripple 58 of the 3rd new R ripple clips.
[embodiment 2]
At this, use Fig. 5,6 that embodiment 2 is described.Difference from Example 1 is: measurement section 36 claps diastasis in cycle or each heart claps the end-systole in cycle to measure cardiac measurement value at each heart.
Fig. 5 is the state that the heart claps the diastasis (moment of R ripple) in cycle, is the state that display tense labelling 52 reaches R ripple 54.When reaching the heart and clapping the diastasis (when R ripple) in cycle, when display tense labelling 52 reaches R ripple 54, measurement section 36 measures the cardiac measurement value 80 of the length between the area of heart, the volume of heart, 2 measurement points.The cardiac measurement value 80 that the diastasis that image displaying part 26 is presented at each heart bat cycle is updated.
Fig. 6 is the state that the heart claps the end-systole (heart be minimum volume when, have passed through the stipulated time (T1) afterwards from the moment of R ripple) in cycle.When reaching the heart and clapping the end-systole in cycle, measurement section 36 measures the cardiac measurement value 80 of the length between the area of heart, the volume of heart, 2 measurement points.The cardiac measurement value 80 that the end-systole that image displaying part 26 is presented at each heart bat cycle is updated.Then, measurement section 36, based on the volume of heart of acquisition diastasis and the volume of the heart in the end-systole acquisition in each heart bat cycle of clapping the cycle at each heart, is clapped the end-systole computing in cycle at each heart and upgrades ejection fraction.
Thus, described measurement section measures cardiac measurement value at the end-systole of diastasis or each described heart bat cycle that each described heart claps the cycle, and therefore operator can confirm cardiac measurement value at the end-systole in the diastasis in each heart bat cycle or each heart bat cycle in actual time (current).
[embodiment 3]
At this, use Fig. 7 that embodiment 3 is described.Be with embodiment 1,2 difference: when the ejection fraction measured by measurement section 36 is below threshold value, image displaying part 26 shows the electrocardiographic wave labelling for identifying the heart bat cycle existing for the ejection fraction below threshold value.
Ejection fraction is the evaluation of estimate of the contractile function representing heart, and generally when heart failure, ejection fraction is less than 40%.Threshold value in the present embodiment is set to such as 40% in control part 42.
At this, suppose that by the ejection fraction in the heart bat cycle that R ripple 56 and R ripple 58 clip be below threshold value.When the ejection fraction measured by measurement section 36 is below threshold value, control part 42 claps the mode in cycle according to the heart existing for the ejection fraction below energy recognition threshold, as as shown in Fig. 7 (a), image displaying part 26 is shown for clapping the electrocardiographic wave labelling 62 that identifies of cycle to the heart existing for the ejection fraction below threshold value.Electrocardiographic wave labelling 62 represents by the line type (thick line, dotted line etc.) different from electrocardiographic wave 50 on electrocardiographic wave 50, or represents by the color different from electrocardiographic wave 50 (red, blue etc.) on electrocardiographic wave 50.
Ejection fraction is different because of condition of illness.Operator can be changed according to the condition of illness wanting to observe the threshold value be set in control part 42 by operating portion 40.Thus, operator can identify that the heart conformed to condition of illness claps the cycle.
In addition, operator by the freezing button of press operating part 40, thus can make the faultage image 70 demonstrated at image displaying part 26 freeze by control part 42.Then, operator makes the tracking ball of operating portion 40 rotate, and display tense labelling 52 can be made thus at random to move.If pressed freezing button, then faultage image 70 can not be updated to actual time (current).By the display tense labelling 52 of movement arbitrarily by time accessed faultage image 70 be presented on image displaying part 26.
Then, operator is with reference to electrocardiographic wave labelling 62, as as shown in Fig. 7 (b), if set in the heart bat cycle existing for ejection fraction making display tense labelling 52 move to below threshold value, then the faultage image 70 that there is heart failure probability can be made to be presented on image displaying part 26.Thus, operator can observe the faultage image 70 that there is heart failure probability in detail.
In addition, image displaying part 26 can carry out the circular regeneration of dynamic image to the faultage image 70 in the heart bat cycle existing for the ejection fraction below threshold value.Specifically, image displaying part 26 makes display tense labelling 52 move within the heart bat cycle clipped by R ripple 56 and R ripple 58, faultage image 70 is carried out to the circular regeneration of dynamic image.
Thus, when the ejection fraction of the expression cardiac ejection fraction measured by described measurement section is below threshold value, image displaying part 26 shows the electrocardiographic wave labelling for identifying the heart bat cycle existing for the ejection fraction below threshold value, so operator can observe in the mode of dynamic image the faultage image 70 that there is heart failure probability in detail.
[embodiment 4]
At this, Fig. 8 is used to be described embodiment 4.Be with embodiment 1 ~ 3 difference: image displaying part 26 shows the cardiac measurement value in the faultage image of different section.
The cardiac measurement value 82 in apex four chamber picture (A4C) is measured in advance, and stores together with the RF signal frame data in apex four chamber picture (A4C) or faultage image data in not shown storage part.By reading cardiac measurement value 82 from storage part, thus image displaying part 26 can be made to show the cardiac measurement value 82 in apex four chamber picture (A4C).
The faultage image 70 demonstrated in image displaying part 26 is apex two chambeies picture (A2C).Measurement section 36, for the faultage image 70 in apex two chamber picture (A2C) being updated to actual time (current), measures the cardiac measurement value such as length, ejection fraction between area in the heart bat cycle set by the 2nd signature waveform of the 1st up-to-date signature waveform and and then the 1st signature waveform, heart, the volume of heart, 2 measurement points.Upgrade cardiac measurement value 80 and be presented on image displaying part 26 together with faultage image 70.
Like this, image displaying part 26 can be made to show the cardiac measurement value 80 in apex two chamber picture (A2C) and the cardiac measurement value 82 in apex four chamber picture (A4C).
Thus, shown the described cardiac measurement value in the described faultage image of different section by image displaying part 26, by showing the cardiac measurement value 80,82 in the faultage image of different section, thus operator can carry out high-precision diagnosis.
In addition, although not shown, but the RF signal frame data or faultage image data that store in storage part can also be read, the faultage image in apex four chamber picture (A4C) is presented on image displaying part 26 together with the faultage image 70 in apex two chamber picture (A2C).When the faultage image of display apex four chamber picture (A4C), by making the signature waveform that gets in apex four chamber picture (A4C) consistent with the signature waveform got in apex two chamber picture (A2C), thus can show matchingly with the heart of the faultage image 70 in apex two chamber picture (A2C) cycle of clapping.
In addition, measurement section 36 can also use the faultage image in apex four chamber picture (A4C) read from storage part to measure the cardiac measurement value such as length, ejection fraction between the area of heart, the volume of heart, 2 measurement points, and cardiac measurement value 82 is presented on image displaying part 26.
Symbol description
10 subjects, 12 ultrasound probes, 14 sending parts, 16 acceptance divisions, 18 ultrasonic transmission/reception control parts, 20 phase modulation adders, 22 faultage image constituting portion, 24 black and white scan converters, 26 image displaying parts, 30 electrocardiographic wave test sections, 32 signature waveform test sections, 34 hearts clap cycle set portion, 36 measurement section, 40 operating portions, 42 control parts.

Claims (14)

1. a medical diagnostic imaging apparatus, possesses:
Faultage image constituting portion, it forms the faultage image of subject;
Measurement section, it measures cardiac measurement value based on described faultage image; With
Image displaying part, it shows described faultage image and described cardiac measurement value,
The feature of described medical diagnostic imaging apparatus is also possess:
Signature waveform test section, it detects signature waveform according to the shape of the electrocardiographic wave of described subject; With
The heart claps cycle set portion, its setting heart claps the cycle, this heart cycle of clapping be by the signature waveform detected by described signature waveform test section among and signature waveform that time difference between fiducial time is minimum be set to the 1st signature waveform and cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform
Described measurement section measures cardiac measurement value based on described faultage image, described signature waveform and the described heart cycle of clapping,
When the ejection fraction of the expression cardiac ejection fraction measured by described measurement section is below threshold value, the electrocardiographic wave labelling of described image displaying part display for identifying the heart bat cycle existing for the ejection fraction below threshold value.
2. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Described measurement section measurement index value, this desired value represents that clapping by the described heart the described heart that cycle set portion sets out claps the relaxing period in cycle and Syst cardiac measurement value or causing circulatory function.
3. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
The fiducial time that the described heart is clapped in cycle set portion is actual time and current time.
4. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Described signature waveform be the R ripple of described electrocardiographic wave, P ripple, Q ripple, S ripple, T ripple any one.
5. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Described medical diagnostic imaging apparatus possesses the operating portion that the faultage image demonstrated described image displaying part sets multiple measurement point,
Described measurement section measures at least one cardiac measurement value of the area of heart, the volume of heart, the ejection fraction of heart based on set multiple measurement points.
6. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Whenever described signature waveform test section detects the signature waveform made new advances, the described heart is clapped cycle set portion and is set the heart bat cycle according to the 2nd signature waveform of the 1st signature waveform newly detected and and then described 1st signature waveform.
7. medical diagnostic imaging apparatus according to claim 6, is characterized in that,
Described measurement section is measured whenever described signature waveform test section detects the signature waveform made new advances and the diastasis in the heart be updated bat cycle and end-systolic cardiac measurement value.
8. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Described measurement section measures cardiac measurement value at the end-systole of diastasis or each described heart bat cycle that each described heart claps the cycle.
9. medical diagnostic imaging apparatus according to claim 1, is characterized in that,
Described cardiac measurement value in the described faultage image of described image displaying part display different section.
10. a cardiac measurement value display method, is characterized in that, comprising:
Form the step of the faultage image of subject;
The step of signature waveform is detected according to the shape of the electrocardiographic wave of described subject;
The setting heart claps the step in cycle, this heart cycle of clapping be by detected signature waveform among and signature waveform that time difference between fiducial time is minimum be set to the 1st signature waveform and cycle set by the 2nd signature waveform of and then the 1st signature waveform and the 1st signature waveform;
The step that the cycle measures cardiac measurement value is clapped based on described faultage image, described signature waveform and the described heart;
Show the step of described faultage image and described cardiac measurement value; With
When the ejection fraction of the expression cardiac ejection fraction measured is below threshold value, display is used for the step of the heart existing for the ejection fraction below threshold value being clapped to the electrocardiographic wave labelling that the cycle identifies.
11. cardiac measurement value display method according to claim 10, is characterized in that,
Measurement index value in the step of carrying out described measurement, this desired value represents that the set heart claps the relaxing period in cycle and Syst cardiac measurement value or causing circulatory function.
12. cardiac measurement value display method according to claim 10, is characterized in that,
Described fiducial time is actual time and current time.
13. cardiac measurement value display method according to claim 10, is characterized in that,
Described cardiac measurement value display method comprises the step described faultage image being set to multiple measurement point,
In the step of carrying out described measurement, measure at least one cardiac measurement value of the area of heart, the volume of heart, the ejection fraction of heart based on set multiple measurement points.
14. cardiac measurement value display method according to claim 10, is characterized in that,
Whenever detecting the signature waveform made new advances in the step detecting described signature waveform, the 2nd signature waveform of the 1st signature waveform that basis newly detects in the step in setting described heart bat cycle and and then described 1st signature waveform sets the heart and claps the cycle.
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